Prescription Drug Plans: What You Need To Know

Prescription Drug Plans

Some health insurance plans do not fully cover medications, and prescription drug plans fill these gaps, allowing people to get the meds they need at lower prices. Before selecting an option, it's essential to understand how they work and what they cover. Keep reading to learn the basics of prescription drug coverage.

Choosing a Plan

If you're on Medicare, you must select Part D coverage. These plans help pay for many types of medications: common drugs plus those in protected classes to treat severe conditions like cancer and HIV. Part D insurance classifies drugs into four tiers:

  • Tier 1: generic drugs with low copayments
  • Tier 2: brand-name drugs with moderate copayments
  • Tier 3: non-preferred brand name drugs with higher co-payments
  • Tier 4: high-cost prescription drugs

Every Part D plan has a formulary or a list of prescriptions it covers. You should consider these main factors: monthly premiums, deductibles, covered medications, and coverage gap availability.

When To Enroll

Medicare recipients can purchase or switch plans during the annual enrollment period, which usually occurs between October 15 and December 7. If you don't have a Part D plan, you could incur a late enrollment penalty. While you shouldn't rush to pick a plan, you should also keep this annual enrollment period in mind. Grand Anchor Insurance can help you evaluate your options and choose prescription drug plans that best meet your needs.